How much rates vary
Facilitymedian $3,631 · 10th to 90th $776 to $16,218Professionalmedian $2,239 · 10th to 90th $1,380 to $3,467
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $9,772.37 | Facility | None | $2,398.83 | $2,398.83 | $9,772.37 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,380.38 Typical High $1,584.89 | Professional | None | $1,318.26 | $1,380.38 | $1,584.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $3,890.45 Median $10,000.00 Typical High $16,982.44 | Facility | None | $3,890.45 | $10,000.00 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,318.26 Median $2,398.83 Typical High $3,235.94 | Professional | None | $1,318.26 | $2,398.83 | $3,235.94 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,445.44 Typical High $1,949.84 | Professional | 62 · Two surgeons | $870.96 | $1,445.44 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $371.54 Typical High $501.19 | Professional | 80 · Assistant surgeon | $223.87 | $371.54 | $501.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $323.59 Typical High $436.52 | Professional | AS · PA/NP assist | $194.98 | $323.59 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $630.96 Typical High $2,691.53 | Facility | None | $489.78 | $630.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $2,511.89 Typical High $3,548.13 | Professional | None | $1,513.56 | $2,511.89 | $3,548.13 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $776.25 Median $851.14 Typical High $2,884.03 | Facility | None | $776.25 | $851.14 | $2,884.03 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,412.54 Median $1,905.46 Typical High $3,715.35 | Professional | None | $1,412.54 | $1,905.46 | $3,715.35 |
United Setting Facility Modifier None Typical Low $776.25 Median $933.25 Typical High $2,884.03 | Facility | None | $776.25 | $933.25 | $2,884.03 |
United Setting Professional Modifier None Typical Low $1,412.54 Median $1,905.46 Typical High $3,715.35 | Professional | None | $1,412.54 | $1,905.46 | $3,715.35 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $660.69 Median $691.83 Typical High $794.33 | Professional | 52 · Reduced service | $660.69 | $691.83 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $275.42 Typical High $316.23 | Professional | 53 · Discontinued | $263.03 | $275.42 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $1,023.29 Typical High $1,202.26 | Professional | 54 · Surgery only | $977.24 | $1,023.29 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $199.53 Median $208.93 Typical High $239.88 | Professional | 55 · Aftercare only | $199.53 | $208.93 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $138.04 Typical High $158.49 | Professional | 56 · Pre-op care only | $131.83 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $954.99 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $912.01 | $954.99 | $1,122.02 |
Where New Hampshire sits
The same service costs 8.9 times more in Maine than in Maryland. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
ME $17,627MD $1,975
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.